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Biomedical subjects

E Walther

Publications and source records attributed to E Walther.

At least 37 records · Page 2Linked to original sources
PubMed1989

Conservation therapy for breast cancers other than infiltrating ductal carcinoma.

Pathologic review of 861 Stage I and II breast cancers yielded 152 patients (18%) with histologic types other than invasive ductal carcinoma. All patients had been treated by breast-conserving surgery and radiotherapy, including supplemental radiation to the tumor bed. For 67 patients with predominantly lobular carcinomas, the actuarial overall 5-year survival was 100% and 77% for node-negative and node-positive patients, respectively. The actuarial probability of recurrence in the treated breast (13.5% at 5 years) appeared to be somewhat greater than that observed after treatment of invasive ductal cancers (8.8% at 5 years, P = 0.11). Of 12 mammary recurrences in patients with lobular carcinoma, four occurred at a considerable distance from the original primary and seven were multifocal, involving more than one quadrant in five patients. Of 47 patients with strictly in situ carcinomas, one patient whose axillary nodal status had not been determined subsequently developed distant metastases. Three additional patients developed mammary recurrence, two at the primary tumor site and one in another quadrant. The actuarial 5-year mammary recurrence and overall survival rates were 4% and 98%, respectively. For 27 patients with true medullary cancers, overall survival at 5 years was 90%. One localized mammary recurrence was observed at the site of the original primary. Actuarial mammary recurrence rate was 4% at 5 years. No relapse was observed in ten patients with colloid and one patient with adenoid cystic carcinoma. The authors conclude that, in addition to its well-established efficacy in the treatment of infiltrating ductal carcinomas, the combination of tumor excision and radiotherapy appears to provide adequate local control for other histologic types as well. However, patients with lobular cancer appear to be at somewhat greater risk of mammary failure, and recurrences in such patients tend to be multifocal and multicentric.

Adenocarcinoma, Mucinous↗
PubMed1989

[Unusual course of malignant synovioma of the flexor tendon sheath of the hand].

The authors report a synovial sarcoma of the hand with an unusual case history and a favorable outcome after two years. A forty-four-year old woman suffering from uncharacteristic pain in the right hand with slightly abnormal EMG-findings for the median nerve was treated by operative release of the carpal tunnel. No unusual findings were discovered intraoperatively. The patient continued suffering from disabling pain for another year so that a second operation was performed by another surgeon. He discovered a tumor behind the median nerve which could not be removed radically because of profuse bleeding. In spite of diagnosing a sarcoma, the patient refused further surgery, however combined radio- and chemotherapy was administered for one year. The tumor was reduced in size but did not disappear. Following open biopsy and proved presence of sarcoma, the remaining tumor was removed by amputating the ulnar part of the hand. Two years following this last operation, the patient is free of local symptoms and there is no evidence of metastases.

Adult↗
PubMed1989

[Initial results of studies of the effect of solar UV irradiation on the curative effect of psoriasis vulgaris in Heiligendamm].

By simultaneous registration of individual dose of natural UV radiation and clinical determination of variation of skin lesions of patients with psoriasis vulgaris was derived a good correlation between both parameters. Furthermore, there were large differences in utilization of UV-light by patients. There are great reserves of a more effective therapy with solar radiation.

Follow-Up Studies↗
PubMed1989

[Breast saving therapy: diagnostic problems in after care].

From 1.1.1977 through 31.12.1985 two hundred seventy-five patients with stages pTis, pT1-2, pN0-1, cM0 breast cancer were treated by breast-conserving therapy. Six patients (2%) were lost to follow-up. Fifty-four patients developed significant subcutaneous or parenchymal induration in the treated breast. The induration was considered clinically suspicious for recurrence in 30/54 and non-suspicious in 24/54. Of the 30 suspicious indurations mammography was diagnostic or suggestive of recurrence in 12 (40%), and the diagnosis of recurrence could be confirmed microscopically in 16 (53%). Mammography showed no pathologic findings in 14/30 (42%) patients with suspicious indurations, and in 12/30 (40%) the impression of benignity was also confirmed microscopically. In patients whose mammograms were diagnostic or suggestive of tumor, malignancy was demonstrated by pathologic examination in all cases. In 21/24 (87.5%) clinically benign indurations no tumor could be found on microscopic examination. Twenty of these patients had a normal mammogram, and in only 1 of these was a recurrence discovered incidentally during a cosmetic operation. Four of the 24 patients with clinically benign indurations had pathologic mammograms, and in 2 of these the diagnosis of recurrence was established histologically. - The rate of agreement between suspicious clinical and mammographic or microscopic findings was about 50%, whereas the correlation for clinically benign indurations was greater than 80%.

Biopsy, Needle↗
PubMed1988

[Treatment of aggressive fibromatosis (desmoid). Reducing the rate of recurrence by postoperative irradiation].

Thirty-three patients with desmoid tumors were treated from 1 January 1970 through 31 December 1983 at the University Hospital in Basel. Twenty-nine patients were treated primarily by surgery in an attempt to cure. Sixty percent of these patients (17 of 29) suffered a subsequent recurrence. Of these 17 patients, 12 were treated with radiotherapy after a second operation. As a result, the recurrence rate was reduced to 25% (3 of 12). Following the initial tumor resection, 4 patients were treated by radiotherapy in an effort to cure. All 4 patients remain free of recurrence, with a median follow-up time of 56 months. The postoperative recurrence rate is dependent on age. No recurrences were observed in patients older than 40. In the younger patients, an increasing recurrence rate was observed the younger the patient. Radiotherapy can contribute to improved prognosis for desmoid tumors under the following circumstances: (1) when the tumor cannot be resected with histologically clear margins, or when resection margins are questionable; (2) when the patient is 30 years old or younger; (3) when the tumor is inoperable, or resectable only by means of a mutilating operation. For patients between 30 and 40 years of age, the question of postoperative radiotherapy should be discussed with the radiation oncologist, even following a microscopically complete resection.

Adolescent↗
PubMed1986

[Nutritional status and small intestine absorption].

A high percentage of hospitalized patients are malnourished. By means of biochemical examinations (visceral proteins), anthropometric measurements (body mass, triceps skinfold, arm muscle circumference, creatinine index) and immunological methods (total lymphocyte count in the blood, skin testing with test antigens) it is possible to classify nutritional conditions in severity and kind of malnutrition. 158 patients with chronic inflammatory diseases of the GI-tract and cancer without generalization were studied by means of an exact nutritional assessment and by means of the modified D-xylose test. There was no significant correlation between the degree of malnutrition and the extent of intestinal absorption. Only in 5.7 per cent of malnourished patients existed a malabsorption.

Female↗
PubMed1986

[Adverse effects of total body irradiation for bone marrow transplantation: prevention and therapy. Experience at Basel, July 1979-March 1986].

Acute toxicity, delayed complications and the incidence of interstitial pneumonitis (IP) after total body irradiation (TBI) are reviewed. Between July 1979 and March 1986 118 patients with hematological malignancies underwent bone marrow transplantation (BMT): all were conditioned with cyclophosphamide and TBI. 106 patients received single dose irradiation (18 with lung-shielding) and 12 had fractionated TBI. Except for mucositis all other symptoms of acute toxicity such as fever, vomiting, parotitis, headache and abdominal pain were usually of short duration. Fractionated TBI did not produce less acute side effects than single dose irradiation. Irradiation, and particularly the maximum lung dose, plays an important role in the multifactorial pathogenesis of IP. Delayed complications may appear several months or years after TBI. The majority of men suffer definitive sterility caused by azoospermia. In women primary ovarian failure and permanent sterility is a common sequela of BMT with TBI. The risk of developing cataracts after single dose TBI is about 80%, and surgical repair was necessary in 43% of these cases. Secondary tumors after TBI have been reported. So far we have observed no secondary malignancies in our patients after BMT. Rampant dental decay can be avoided by careful dental prophylaxis.

Adolescent↗
PubMed1986

[Do pathologico-anatomic parameters modify the incidence of recurrence following conservative breast surgery and radiotherapy?].

201 breast cancer patients (pT1-2, pN0-1) were treated with conservative breast surgery and radiation therapy. 28 (13.9%) treatment failures, -13 (6.5%) local recurrences, 4 (2.0%) axillary - and 11 (5.5%) distant metastases -, were found overall after a mean follow-up of 47 months. The differences between pT2 and pT1-tumors (20.6% vs 10.5%) and nodal positive versus nodal negative patients (28.1% vs 6.8%) are statistically significant. No differences were seen regarding histological features.

Breast↗
PubMed1984

[Simultaneous studies of granulocyte phagocytosis, serum immunoglobulins, acute phase proteins and the 3d complement component in patients with malignant tumors].

In a clinical study granulocyte phagocytosis, serum levels of IgG and IgA and of the acute phase proteins ceruloplasmin, alpha-1-antitrypsin, transferrin, and of the 3rd component of complement (C3) are simultaneously determined in tumor patients and compared with healthy probands of the same age and with patients being under general surgical treatment. There was found a negative correlation between granulocyte phagocytosis and the IgG level and a positive correlation between phagocytosis and the C3 level in each group. Despite of some significant differences between all groups of probands with respect to the measured parameters no new essential information for clinical use could be received, thus the determination of granulocyte phagocytosis remains the only recommended method.

Acute-Phase Proteins↗
PubMed1980

[Thymoma: therapeutic and diagnostic aspects].

Ten patients with malignant inoperable thymoma were treated January 1972 and December 1978 in the Department of Radiotherapy, University Hospital, Basel. The average age at the time of diagnosis was 36 years. The youngest patient with an ectopic thymoma was 5 1/2 years old and the oldest 66. Accompanying autoimmune diseases were not observed. Histological verification was obtained 9 times by biopsy and once by tumor excision: 3 patients had a fusiform cell thymoma, 3 presented with a mixed-cell thymoma, 2 patients had a granulomatous and 2 mainly an epithelial or unclassified type of thymoma. Four patients died. One died within one year from generalized varicella infection and was free from tumor at autopsy. The other three developed metastases later. One developed a recurrence 2 1/2 years after receiving 6500 rads; following resection, a radiogold implant was given and additional irradiation of 4000 rad administered. Eighteen months later this patient developed lung metastases which exhibited slow progression under chemotherapy. 5 3/12 years after beginning of treatment laminectomy was performed, in the postoperative phase of which the patient contracted edema of the lung and died. The operation site showed a large recurrence invading the spinal channel per continuitatem. The other two patients died 1 3/12 years after the beginning of radiotherapy in spite of chemotherapy for disseminated metastases. Six patients who have been followed-up for one to 5 5/12 years are asymptomatic and show no evidence of disease. The dose administered was 4200-6500 rads. The therapeutic approach and factors affecting prognosis are discussed. In the experience of the authors and others, the best results are achieved with surgery and curative irradiation.

Adolescent↗